As of December 2025, approximately 9,022 people are on the national liver transplant waiting list in the United States. That number shifts daily as new patients are added, transplants are performed, and others are removed for various reasons. While the waitlist figure can sound alarming, it tells only part of the story. Record-breaking transplant numbers, growing use of living donors, and a sophisticated priority system all shape what the wait actually looks like for individual patients.
How the Waitlist Number Changes Over Time
The roughly 9,000 people on the list at any given moment is a snapshot, not a fixed population. Over the course of a full year, far more people cycle through. In 2023, for example, 14,747 candidates were removed from the waiting list by year’s end. About 64.5% of those removals happened because the patient received a liver from a deceased donor. Another 3.9% received a living-donor transplant. So the majority of people removed from the list got the organ they needed.
Not all removals are positive, though. Around 6.4% of candidates removed in 2023 died while waiting, and another 6.6% became too sick to safely undergo transplant surgery. About 7.5% were removed because their condition actually improved enough that they no longer needed a transplant, and the remaining 11.1% were removed for other reasons.
Record Transplant Numbers in Recent Years
The number of liver transplants performed in the U.S. has been climbing steadily. In 2025, a record 12,344 liver transplants were completed, nearly 8% more than the year before. That growth has been driven partly by better organ preservation techniques and partly by an increase in living-donor transplants.
Living donation accounted for 709 of those 2025 transplants, a 17% jump over the previous year. In a living-donor liver transplant, a healthy person donates a portion of their liver, which then regenerates in both the donor and the recipient. While living donation still represents a small share of all liver transplants (around 6% historically), its rapid growth is helping chip away at the gap between supply and demand.
How Patients Are Prioritized
The waiting list is not a first-come, first-served line. Patients are ranked primarily by medical urgency using a scoring system called MELD 3.0 (Model for End-Stage Liver Disease). This score estimates how likely a patient is to die without a transplant in the near term, and the sickest patients get priority.
MELD 3.0 calculates a score from 6 to about 40 based on several blood test results that reflect how well the liver and kidneys are functioning: bilirubin (a waste product the liver clears), creatinine (a measure of kidney function), sodium levels, and albumin (a protein the liver produces). The updated version of the score also accounts for sex-based differences in how these lab values predict mortality, correcting a historical disadvantage that women faced under the older formula.
Patients with the highest MELD scores get organs first. Those listed as the most medically urgent (MELD scores of 35 or higher, or designated status 1A for acute liver failure) typically wait less than a week. The median wait for this group is just about seven days. For patients with moderate scores in the 15 to 34 range, the median wait has dropped to roughly 5.6 months, down from 8.5 months in earlier years. Patients with lower scores, whose livers are still functioning reasonably well, can wait considerably longer or may never reach a high enough priority to receive an offer.
Why People Need Liver Transplants
The conditions that land someone on the transplant list generally fall into a few categories. Chronic liver diseases like cirrhosis from alcohol use, fatty liver disease, or hepatitis are the most common. Liver cancer, particularly a type called hepatocellular carcinoma, also qualifies patients for listing and receives special consideration in the scoring system. Less frequently, acute liver failure from drug reactions or other sudden causes can place someone at the very top of the list almost immediately.
Alcohol-associated liver disease has been rising as a primary diagnosis for transplant candidates in recent years, while hepatitis C has declined significantly thanks to antiviral treatments that can now cure the infection before it destroys the liver.
What Waiting Actually Looks Like
Being on the transplant list is not a passive experience. Patients undergo regular blood tests to update their MELD score, and their position on the list shifts as their condition changes. If your liver function worsens, your score rises and you move up in priority. If it stabilizes or improves, you may move down or even be removed from the list entirely.
Geography also plays a role. Organs are first offered to the sickest patients within a certain radius of the donor hospital, then to progressively wider areas. This means two patients with identical MELD scores can have very different wait times depending on where they live, how many donor organs become available locally, and how many other candidates are competing in that region. Some transplant centers encourage patients to list at multiple hospitals in different areas to improve their chances, though this adds complexity and cost.
Blood type matters as well. Patients with type O blood tend to wait longer because type O organs can be matched to recipients of any blood type, spreading the supply thinner. Patients with less common blood types sometimes benefit from a smaller pool of competing candidates.
The Gap Between Supply and Demand
Despite record transplant volumes, the waiting list persists because the number of people developing end-stage liver disease continues to grow. Rising rates of obesity-related fatty liver disease and alcohol use have expanded the pool of patients who eventually need transplants. The 9,022 people waiting at any given time represent a balance point: new listings are roughly keeping pace with transplants performed, but not everyone who needs an organ gets one in time.
The combined death and “too sick to transplant” removal rate of about 13% in 2023 means that roughly 1 in 8 patients removed from the list that year lost their chance at a transplant. That number has improved over the past decade as transplant volumes have increased, but it remains a significant gap. Efforts to close it include expanding living-donor programs, using organs from donors previously considered too risky, and improving preservation methods that keep donated livers viable for longer.